Psoriasis on the nipple and areolae may look like circular, raised, red lesions with overlying dryness or scaling. One or more lesions may be present. Psoriasis is usually painless unless the lesions become infected or have skin breakdown. Women with a history of psoriasis in other areas of the body are more prone to develop lesions on the nipple and areolae while breastfeeding. (see photo)
****Smaller psoriatic plaques may look like a fungal infection, so make sure to see your doctor to get the proper diagnosis and treatment. Improperly treating a fungal rash with a corticosteroid will worsen the fungus.****
The treatment of psoriasis on the nipple and areolae is to use a mild to moderated corticosteroid over the lesion after nursing or pumping. Significant improvement is usually seen within the first week and may take up to 2 weeks for complete resolution.